Impact of Prehabilitation in Total Knee Replacement

Allina Health System

Status: Completed

Conditions: Total Knee Arthroplasty

Treatments: Other: Prehabilitation

Study type: Interventional

Funder types: Other

Identifiers

NCT01844934

Study 3963-2 IRB

Details and patient eligibility

About

A study comparing the benefits of pre-habilitation exercise to standard care prior to total knee arthroplasy

Full description

Recovery post Total Knee Replacement Surgery ((TKA) has been a subject of interest. In a study of 379 patients who had hip or knee replacement surgery, it was reported that at 6 months post-surgery patients with better baseline function had superior functional ability and less pain than patients with lower function at baseline. Another study of 276 patients undergoing TKA reported that pre-operative joint function was a predictor of joint function and overall function at 6 months post-surgery. These findings suggest that prehabilitation to increase functional ability prior to TKA may have a positive effect in recovering post-surgery. In a randomized control trial of patients receiving TKA, the group receiving an Exercise Program (prehabilitation) made significant improvements in performance from baseline to before surgery, and at 1 and 3 months post surgery. For the group that did not receive the Exercise Program pre-surgery, significant improvement did not occur until 3 months post surgery. The overall objective of the proposed single-blinded randomized controlled trial is to demonstrate that a well designed prehabilitation program for patients receiving TKA surgery will significantly improve outcomes related to pain and function and may reduce utilization of health care services post surgery.

In this randomized control trial we hypothesize that the group of participants who receive a prehabilitation Exercise Program will recover quicker than patients who do not receive the Exercise Program based on several measures of performance including pain, quadriceps strength, range of motion and quality of life.

Enrollment: 43 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients scheduled to undergo unilateral TKA surgery
• Ambulatory
• Community dwelling (living at home)
• Able to participate in moderate intensity exercise
• American Society of Anesthesiologists Physical Status Classification(ASA) 1 - 3
• Speaks English

Exclusion criteria

• Patients who are planning a second surgery of the lower limbs during the six months post-surgery
• Have the effect of peripheral vascular disease or stroke on walking

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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43 participants in 2 patient groups

Standard treatment

No Intervention group

Description:

The no intervention group will receive standard treatment that includes a four hour class pre-surgery consisting of a description of the surgery, what to expect in the hospital and during recovery and some exercises to be done in preparation for surgery.

Prehabilitation

Experimental group

Description:

Prehabilitation:The experimental group will receive a three week prehabilitation program prior to surgery in addition to standard treatment.

Treatment:

Other: Prehabilitation